Local Delivery of Silk-Cellulose Incorporated with Stromal Cell-Derived Factor-1 alpha Functionally Improves the Uterus Repair

Severe infection and mechanical injury of the uterus may lead to infertility and miscarriage. Currently, there is a lack of effective treatment modality for functional repair of uterine injury. To address this clinical challenge, this study aimed to develop a chemotactic composite scaffold by incorporating recombinant human stromal cell-derived factor-1 alpha (rhSDF-1 alpha) into a silk fibroin-bacterial cellulose (SF-BC) membrane carrier. A rat model of uterine injury was utilized for this study, which was composed of three groups as follows: blank control, implantation with SF-BC only, or SF-BC loaded with rhSDF-1 alpha. The tissue regeneration efficacy of the three groups was analyzed and compared. The results showed that SF-BC loaded with rhSDF-1 alpha significantly enhanced endometrial regeneration and arteriogenesis of the injured rat uterus, which led to improved pregnancy outcomes, thus indicating much promise for functional uterine repair and regeneration. Impact Statement In this study, we demonstrated that the silk fibroin-bacterial cellulose (SF-BC) membrane possessed good physical, chemical, and biocompatibility properties in vitro. The in vivo study showed that the incorporation of recombinant human stromal cell-derived factor-1 alpha (rhSDF-1 alpha) within the SF-BC membrane promoted regeneration of full-thickness uterine injury and also improved the pregnancy outcome of the damaged uterus. The results thus suggest that SF-BC loaded with rhSDF-1 alpha has good potential in future clinical applications for the repair of uterine injury.